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In ConSumo, you control a sumo wrestler, and your main goal is to eat your way to win. You have three lives. Your sumo can move in the eight cardinal directions. He cannot move off the edge of the mat, although if he is bounced off the edge of the screen by one of the other sumo wrestlers in the game he will respawn at the center of the screen with no penalties.

Icons of fresh and rotten food as well as puffer fish and other sumo wrestlers drift across the screen in straight lines. You must eat the fresh food to gain weight. As more weight is gained, your "weight gauge" gradually fills. Rotten food causes your weight gauge to decrease.

Each time it is filled, you become bigger, making it more difficult to dodge the hazards. The food and hazards also become bigger as well, and they fill or empty your weight gauge in increasing amounts the larger they get.

The other sumo wrestlers cause you to bounce away from them, which can send you into the pathway of rotten food or a puffer fish.

A puffer fish causes you to instantly lose a life. You can also lose a life if you eat rotten food when there is no room for your weight gauge to decrease.

As you progress in the game bad items will appear more frequently, such as blowfish, rotten apples etc.

To gain the use of the bedroom in the basement of Dragon's Wing Comic Store, Jimmy has to beat Fatty's high score. Once Jimmy does it, he can either keep playing or lose all of his lives to finish the mission.